Hallux abducto valgus is a progressive deformity of the foot commonly referred to as a "bunion" and is most often painful to those afflicted therewith. The condition is visible as a reddened, arthritic enlargement at the base and innerside of the great or "big" toe and is often quite unsightly. It is seen in a wide variety of groups, beginning with juvenile onset in children to the crippling end stage in the elderly.
Bunion deformities are the result of a hereditary structural fault genetically transmittable by way of a dominant gene which is present in approximately sixty-five per cent of the population. The structural fault causes gradual drifting of the big toe away from the mid-line of the body and toward the mid-line of the foot itself when the individual's weight is brought to bear upon the afflicted foot while walking or even standing. This drifting causes the collapse of the longitudinal arch of the foot and rubbing of the innerside of the big toe against the inside of a patient's shoe thus causing the formation of an enlargement thereon or further aggravation of a bunion. The drifting also causes severe pressure problems for the lesser toes (2-3-4-5) and usually results in hammer toes, corns, callouses, ingrown toe nails, etc.
Progression of the condition is spurred onward with improperly designed, yet fashionable, pointy-toed shoes. Thus, bunion deformities predominantly plague the female population more than the male population. Females further disproportionately represent those with advanced cases of the condition due to the fact that they have relatively weakened bone structure and lack supportive muscle tone.
Treatment of the disorder depends upon its level of advancement in a particular patient. Although methods differ, surgical treatment is usually resorted to only during the late stages of bunion development. Some conservatives resort to surgery only when the condition is so advanced and painful that oral pain relievers are ineffective for the afflicted individual to merely carry out his/her daily activities. Orthotic arch devices to limit the collapse of the longitudinal arch of the foot and hence arrest, or at least retard, the progression of the condition offer conservative alternatives to bone-cutting surgery if prescribed at an early stage.
These orthotic devices usually take the form of podiatrically prescribed orthotic arch inserts for placement within a shoe and under the bottom of a patient's foot from heel to toe successfully. They serve to support the longitudinal arch of the afflicted foot, realign the foot and toes and thus limit drifting of the great toe when the individual's weight is brought to bear on the afflicted foot. This effect can be seen by X-ray.
Orthotic arch inserts have additionally found application for many foot disorders other than bunions including numerous congenital disabling structural/boney defects (e.g., heel spur syndrome, flat foot, painful plantar calluses, hammer digit or "cock-toe" syndrome of the lesser toes 2-3-4-5, interdigital corns). Orthotic arch inserts have also been successfully used to treat metabolically disabling diseases which further deform the foot beyond surgical control (e.g., rheumatoid arthritis, multiple sclerosis, polio, muscular dystrophy).
Orthotic inserts are also usually prescribed after corrective bunion surgery in order to maintain the structural correction achieved by surgery and to prevent reoccurrence of the condition due to inherited ankle weakness (reoccurrence without continued use of orthotic inserts on a daily basis is common).
As can be appreciated, the orthotic insert described above is a valuable therapeutic device and is often a viable alternative to painful bone surgery. It provides boney structural support, controlled muscle function and prolonged ambulatory comfort for the user. However, its use requires that it be worn with a "deep" and stable shoe (e.g. "oxford style" shoe), usually a lace-up style shoe, for maximum control of the weight bearing process. As can also be appreciated, a user of an individually crafted orthotic arch insert is significantly limited in the type of shoes he or she can wear. This limitation is disturbing to a large number of those individuals whose conditions can be aided by the use of orthotic inserts. Further, deep, stable, lace-up shoes are not currently considered fashionable or appropriate attire. Ironically, the use of orthotic inserts has been met with the most resistance by females who are disproportionately represented in the population of those with foot disorders which can be alleviated by the use of orthotic inserts.
As can be appreciated from the foregoing, there is need for a wider variety of shoe styles with which a user can use an orthotic insert and obtain the benefits therefrom. There is a further need for attractive shoes with which a user can use an orthotic insert.